Behavioural approach to treating phobias

What is systematic desensitisation (SD)?

A behavioural therapy designed to gradually reduce phobic anxiety by classical conditioning, if person can relax in the presence of a phobic stimulus they are cured

What is the procedure of SD?

1) therapist and patient putting together an anxiety hierarchy, arranging situations relating to phobic stimulus from least to most frightening

2) relaxation techniques are taught, as it is impossible to be both relaxed and scared— reciprocal inhibition, such as clients taught to imagine themselves in relaxing situations when faced with phobic stimulus

3) exposure to phobic stimulus while in relaxed states treatment is successful when client can stay relaxed in situations high on the anxiety hierarchy

What is flooding?

Immediate exposure to phobic stimulus without a gradual build up in anxiety hierarchy

Longer than SD sessions, 1 session lasts 2-3 hours

How does flooding work?

Extinction: without the option of avoidance behavior, client quickly learns that the phobic stimulus is harmless, as the learned reasoned is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus, and as a result the conditioned stimulus no longer produced the conditioned response

Informed consent is important as it could be traumatic so they need to be fully prepared

What did Smith and Glass’ meta analysis of effectiveness of SD find?

SD effect size 0.91 based on 223 studies

Flooding effect size 0.64 based on 45 studies

Both are more effective than controls

What did Gilroy’s follow up of 42 SD patients find?

At both 3 and 33 months, SD group was less fearful of spiders than a control group treated with relaxation without exposure

What is symptom substitution?

When behavioural therapies only mask symptoms and don’t tackle the underinvestment cause of it, which leads to another phobia developing shortly after

What is a case that Pearson found about symptom substitution?

A woman with a phobia of death who was treated with flooding had her fear of death decline but her fear of being criticised got worse